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B Douglas Ford

Publications and source records attributed to B Douglas Ford.

5 recordsLinked to original sources
PubMed2005

The relationship between hospital infection surveillance and control activities and antibiotic-resistant pathogen rates.

BACKGROUND: Antibiotic-resistant pathogen rates are rising in Canada and the United States with significant health and economic costs. The examination of the relationship of surveillance and control activities in hospitals with rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile -associated diarrhea (CDAD), and vancomycin-resistant Enterococcus (VRE) may identify strategies for controlling this growing problem. METHODS: Surveys were sent to infection control programs in hospitals that participated in an earlier survey of infection control practices in Canadian acute care hospitals. RESULTS: One hundred twenty of 145 (82.8%) hospitals responded to the survey. The mean MRSA rate was 2.0 (SD 2.9) per 1000 admissions, the mean CDAD rate was 3.8 (SD 4.3), and the mean VRE rate was 0.4 (SD 1.5). Multiple stepwise regression analysis found that hospitals that reported infection rates by specific risk groups ( r = -0.27, P < .01) and that kept attendance records of infection control teaching activities ( r = -0.23, P < .01) were associated with lower MRSA rates. Multiple stepwise regression analysis found that larger hospitals ( r = 0.25, P < .01) and hospitals at which infection control committees or staff had the direct authority to close a ward or unit to further admissions because of outbreaks ( r = 0.22, P < .05) were associated with higher CDAD rates. Multiple logistic regression analysis found that larger hospitals (OR, 1.6; 95% CI, 1.2-2.0; P = .003) and teaching hospitals (OR, 3.7 95% CI, 1.2-11.8; P = .02) were associated with the presence of VRE. Hospitals were less likely to have VRE when infection control staff frequently contacted physicians and nurses for reports of new infections (OR, 0.5; 95% CI, 0.3-0.7; P = .02) and there were in-service programs for updating nursing and ancillary staff on current infection control practices (OR, 0.2; 95% CI, 0.1-0.7; P = .01). CONCLUSION: Surveillance and control activities were associated with MRSA and CDAD rates and the presence of VRE. Surveillance and control activities might be especially beneficial in large and teaching hospitals.

Canada↗
PubMed2003

The state of infection surveillance and control in Canadian acute care hospitals.

BACKGROUND: Nosocomial infections and antibiotic-resistant pathogens cause significant morbidity, mortality, and economic costs. The infection surveillance and control resources and activities in Canadian acute care hospitals had not been assessed in 20 years. METHODS: In 2000, surveys were mailed to infection control programs in all Canadian hospitals with more than 80 acute care beds. The survey was modeled after the US Study on the Efficacy of Nosocomial Infection Control instrument, with new items dealing with resistant pathogens and computerization. Surveillance and control indices were calculated. RESULTS: One hundred seventy-two of 238 (72.3%) hospitals responded. In 42.1% of hospitals, there was fewer than 1 infection control practitioner per 250 beds. Just 60% of infection control programs had physicians or doctoral professionals with infection control training who provided services. The median surveillance index was 65.6/100, and the median control index was 60.5/100. Surgical site infection rates were reported to individual surgeons in only 36.8% of hospitals. CONCLUSIONS: There were deficits in the identified components of effective infection control programs. Greater investment in resources is needed to meet recommended standards and thereby reduce morbidity, mortality, and expense associated with nosocomial infections and antibiotic-resistant pathogens.

Acute Disease↗